Immunostaining for cytokeratin 20 improves detection of micrometastatic Merkel cell carcinoma in sentinel lymph nodes - 01/09/11
Abstract |
Background: Sentinel lymph node biopsy (SLNBx) can identify Merkel cell carcinoma (MCC) micrometastasis. Objective: We attempted to examine the effectiveness of immunostaining and identify antibodies most appropriate for evaluation of SLNBxs for MCC. Methods: Histopathologic material from 10 patients with MCC who had SLNBx was reviewed. Results: Twenty-three SLNBxs from 10 patients appeared tumor-free in routine hematoxylin-eosin (H&E)-stained sections. However, tumor cells were detected in immunostained sections from 5 (22%) of 23 SLNBxs in 4 (40%) of 10 patients. Immunostains with pancytokeratin (panCK), cytokeratin-20 (CK-20), neurofilament protein, and chromogranin A were used for all primary and SLNBx specimens. All 5 (100%) micrometastatic foci stained strongly for CK-20 and panCK. Background normal lymph node tissue also stained for panCK but not for CK-20. Conclusion: Examination of H&E sections alone is insufficient for excluding micrometastatic MCC in sentinel lymph nodes. We observed the greatest sensitivity and specificity with anti-CK-20 antibody in identifying micrometastatic MCC in sentinel lymph nodes. (J Am Acad Dermatol 2002;46:661-6.)
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Reprint requests: Timothy M. Johnson, MD, University of Michigan, Department of Dermatology, 1910 Taubman Center, Ann Arbor, MI 48109-0314. |
Vol 46 - N° 5
P. 661-666 - mai 2002 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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